Psych Flashcards
Major Depression requirements for dx
2 weeks with 5 or more symptoms of SIGECAPS if anhedonia or depressed mood
Sleep, interest, guilt, energy,, concentration, appetite, psychomotor (leaden paralysis or antzy), suicide
True or false, hyperparathyroidism can cause depression?
Yes, think calcium and psychiatric overtones
Dopamine blockers canc ause depression
Like metaclopramide, prochlorperazine, haloperidol
Med used for viral hepatitis that causes depression?
Interferon alpha
Atypical depression is what?
Treatment?
Like Karly.
Responds to MAOi’s (though SSRI is first line)
Peripartum depression is up to 4 weeks later. Psychotic features can happen b/c of depression
oh!
Important to differntiate mood disorder secondary to pyschoses and schizoaffective
Persistent depressive disorder
2 years or longer without 2 months without symptoms.
Need depressed mood plus 2 SIGECAPS
Desvenlafaxine, duloxetine, milnacipran, venlafaxine are what?
SNRIs and dizziness, serotonin syndrome, SEX DYSFUNCITON!
Serotonin syndrome sx?
Mental status change, autonomic excitation, neuromuscular hyperactive, OCULAR CLONUS
Drugs that increase risk of serotonin. ESPECIALLY the antibiotic
SSRI, SNRI, MAOIs, St johns, tryptophan (precursur)
LINEZOLID
Tx of serotonin syndrome?
Discontinue
Supportive and vitals
Benzos for sedation
If temp above 41, PARALYZE and mechanically cool
If still agitated, use cyproheptadine
What is cyproheptadine used for?
Still agitated after bento given after serotonin syndrome
it is serotonin antagonist
Neuromalignant syndrome vs Serotonin syndrome?
NMS is gradula onset and rigidity wearas 5HT is hyperkinesis and clonus
both have autonomic instability, hyperthermia and muscle problems
Bupropion mechanism?
what is nice about it?
Bad about it? (contraindications)
weight loss, keeps awake, NO SEXUAL DYSFUNCTION
Lowers seizure threshold
Mirtazapine mechanism. Side effect?
Alpha 2 blocker, so more adrenergic.
Causes sedation and wt gain
TCA overdose
Tri C’s
Cardiotoxic, tachy, hypotension
CNS toxic (coma, seizure)
AntiCholinergic
Tx of TCA overdose?
ABC
Activated charcoal
Cardiac monitoring
DRUG LEVEL
SODIUM BICARB
BENZOS IF SEIZURE
ECT indication
Depression refractory, psychotic depression, severe suicidality, mania, psychosis, rapid response required…
What does bipolar II disorder need for dx?
Major depressive and at least one hypomanic episode
Manic episode requires what for dx?
3 symptoms of DIG FAST
1 weeks
Impair funcitoning or require hospitalization or psychotic feature
Does hypomania impair functioning or cause psychosis?
Nope
Tx bipolar?
Lithium
Anticonvulsants (If renal failure)
Atypical antipsychotics added if above don’t work
ECT could be done
Depression history should be sure to look for episodes of mania.
B/c SSRI could send to mania
Tx for Neph Diabetes Insip if needing lithium?
HCTZ and amiloride b/c amiloride blocks sodium channels that allow sodium into renal cells
Ebstein anomoly is what?
Tricuspid into RV. RV hypoplasia, Regurg. Patent Foramen ovale
Lithium side effects?
LMNOP
Movement Metallic taste
Nephrogen Diab Insip
hypOthyroid (or any thyroid issue)
Preggers issue (ebstein)
Cyclothymic disorder is what?
tx?
2 years of hypomanic or depressive symptoms going back and forth
Tx mood stabilizers and psychotherapy (like mini bipolar!)
Dissociative identity disorder
Derpersonalization/derealization
Id is multiple personalities/identities
Depersonaliztion is detachment from body
Derealization is feelings things around aren’t real )in a dream state)
Panic disorder dx when?
Tx?
4 symptoms causing panic attack
THEN MALADAPTIVE behavior of fear of them. Worry at least one month
Tx by:
CBT
SSRI
Benzos to stop acute panic attack (bentos can cause rebound)
GAD Dx: LENGTH OF TIME?
Tx
Deression and anxiety same monkey in different shirt
Worry happening more days than not for 6 months with at least three symptoms!
Tx:
SSRI, SNRI or BUSPIRONE
CBT can help
Social anxiety tx?
Must be interfering or worrying about them
CBT, SSRI, SNRI
Benzo and Beta blockers may help for performance.
Buspirone is what?
Second line anti anxiety med. Can be added to help the SSRI and SNRI (which are first line)
Affinity for serotonin and dopamine receptors
